Healthcare reform: 'We need to position ourselves'

Sunday, July 12, 2009

WASHINGTON - It was "eerily quiet" on Capitol Hill last week, industry stakeholders say, as the House of Representatives and the Senate struggled to push forward healthcare reform legislation.

"Things are slowing down," said Cara Bachenheimer, senior vice president of government relations for Invacare. "They're having problems building consensus."

While it's a day-by-day, week-to-week process, industry stakeholders expect the House to introduce and begin marking up a healthcare reform bill and the Senate to release a draft bill this week.

Additional details on the House's bill and the Senate's draft were few and far between last week. Industry stakeholders said the House bill will likely include a provision to eliminate the first-month purchase option for standard power wheelchairs, but not complex power wheelchairs. The Congressional Budget Office (CBO) released a score for the provision last week, estimating it will save $900 million over 10 years.

Industry stakeholders continue to lobby lawmakers to remove the provision. AAHomecare last week sent a letter to House and Senate committees overseeing healthcare reform, detailing its concerns that the provision will "diminish access to power wheelchairs for people with a defined medical need."

"Power wheelchairs has been the hardest hit segment in our industry, with a 27% average cut in 2007 and a 9.5% cut this year," said Walt Gorski, vice president of government affairs for AAHomecare. "These cuts are not sustainable."

The House and Senate committees are also hearing from consumer and clinician groups, including the ALS Association, the ITEM Coalition, the National Council on Independent Living and RESNA.

"There continues to be a flurry of activity," said Seth Johnson, vice president of government affairs for Pride Mobility. "It's great that the consumer and clinician organizations are complementing the industry's message."

It doesn't appear that the House bill will include cuts to home oxygen therapy, but industry stakeholders are still crossing their fingers. There was no mention of oxygen, they say, in the House's draft bill, released a few weeks ago, or in the CBO score, released last week.

"There are a lot of rumors about oxygen, but nothing we can pin a tail to," said John Gallagher, vice president of government relations for The VGM Group. "We know there are discussions, but we haven't seen anything."

Even if the industry manages to get through healthcare reform relatively unscathed, industry stakeholders pointed out that Congress also needs to come up with money to prevent a big cut to physician reimbursement from going into effect.

"It's a glass half empty or full kind of thing," Gallagher said. "That could provide the potential for additional cuts or it could provide an opportunity to get the 36-month cap and competitive bidding eliminated. So we need to position ourselves."